What is this Frontal Headache?

Part One

By Colleen Doherty, MD
Headaches & Migraines Expert
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Do You Have a Frontal Headache?. JGI/Jamie Grill/Blend Images/Getty Images

Updated February 19, 2015.

Written or reviewed by a board-certified physician. SeeAbout.com'sMedical Review
Board.

You have a headache smack dab on your forehead. Ouch! Does it feel like
sinus congestion? Or maybe it's a migraine because you have a throbbing
sensation? There are lots of possibilities for a frontal headache. Let's review
the common primary headache disorders that can trigger forehead pain.
Remember, primary headache disorders exist on their own, and are NOT
caused by another medical condition.
Tension Headache
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A tension headache is the most common type of primary headache disorder.
It's characterized by a dull tightening or pressure on both sides of the head,
like a band. It typically starts at theforehead and radiates around to the back
of the head. Unlike a migraine, a tension-type headache is not associated with
nausea or vomiting or with an aura. Sufferers do sometimes report a loss of
appetite and may report photophobia (sensitivity to light) orphonophobia
(sensitivity to sound).
Cluster Headache
A cluster headache is an extremely painful and disabling headache that is
one-sided and occurs around the eye, temple, orforehead. It is often
described as intensely sharp, burning, or piercing. Cluster headache attacks
are accompanied by at least one autonomic symptom on the same side of the
head pain. These autonomic symptoms include: nasal discharge, tearing of
the eye, miosis (pupil constriction), and facial swelling. Most individuals
suffering from cluster headaches are agitated and unable to lie down.
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Migraine
A migraine is a debilitating, neurological condition that occurs usually on one
side of the head, causes a throbbing sensation, lasts 4-72 hours, and is
commonly accompanied with nausea, photophobia,phonophobia, and
sometimes a migraine aura. While a tension headache may be annoying, the
pain is generally mild. A migraine, on the other hand, has a moderate to
severe intensity of pain leading to a greater impairment in your daily
functioning.
Sinus Headache
Sinus headaches are often confused with migraines because both commonly
cause head pain in the forehead. Also, you may get a congested or runny
nose with a migraine. In the vast majority of cases, people (and their doctors!)
think they are suffering from a sinus infection, when they are really having a
migraine.
Clues that you have a frontal sinus infection include:
fever and/or chills
nasal discharge that is thick, colored, and ample
To distinguish from other types of frontal headaches, an otolaryngologist (ENT
doctor) can perform a nasal endoscopy and possibly a CT scan of your sinus
to see if you have a buildup of mucous in your frontal sinus. It can be tricky
though because sometimes the CT scan will show a mucous buildup, but the
cause of your headache is still NOT sinus disease. This is just the reality of
medicine and why the diagnosis of your headaches can be a tedious process.
Hemicrania Contiua

Hemicrania continua is a painful, one-sided headache that occurs all the time
on a daily basis without relief. It is a rare cause of headache but occurs on
the forehead, as well as the temples, around the eyes, or the back of the
head. It is accompanied by at least oneautonomic symptom like: nasal
discharge, tearing of the eye, miosis. This headache type is responsive to
indomethacin, an NSAID.
Quick Note
There are also secondary headaches--headaches caused by a separate
medical condition--that may be causing your frontal headache like:

Giant Cell Arteritis

Brain Tumor

Cervicogenic Headache
These are rare causes though and will be discussed in Part 2: Frontal
Headaches.
Take Home Message
There are a number of primary headaches that may be causing your frontal
headache. Be proactive in your health and talk with your doctor. Getting the
right diagnosis is critical to formulating an effective treatment plan.

Sources
Chow AW, B